Cemented humeral stem<i>versus</i>press-fit humeral stem in total shoulder arthroplasty

Uy, Michael; Wang, J; Horner, Nolan S.; Bedi, Asheesh; Leroux, Timothy; Alolabi, Bashar; Khan, Moin

doi:10.1302/0301-620x.101b9.bjj-2018-1369.r1

Cited by 14 publications

(8 citation statements)

References 61 publications

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“…While studies have evaluated the differences between cemented and press-fit humeral stems at short-term (>2 years of follow-up) and mid-term time points (>5 years of follow-up) [ 2 , 16 ], this is one of the first studies to report on long-term patient reported outcomes comparing cemented and press-fit humeral stems. In our study, we found that both cemented and press-fit humeral stems provide sustained and significant improvements in terms of shoulder function and pain.…”

Section: Discussionmentioning

confidence: 99%

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Li,

Levy,

Duey

et al. 2023

Clin Shoulder Elb

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Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair.Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures.Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75).Discussion: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores.

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Section: Discussionmentioning

confidence: 99%

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Li,

Levy,

Duey

et al. 2023

Clin Shoulder Elb

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“…Recent systematic reviews summarized the results for various implant types: Uy et al reported on stemmed cemented TSA (pooled mean FE: 132°, ER: 37°) vs. pressfit implants (pooled mean FE: 146°, ER: 53°). 27 Liu et al compared stemless TSA vs. stemmed TSA and reported similar postoperative functional outcomes and complication rates as well as a shorter operative time and decreased intraoperative blood loss for stemless implants. 17 The weighted mean postoperative flexion for stemless implants was 142°, and 47° on ER.…”

Section: Discussionmentioning

confidence: 99%

Inlay total shoulder arthroplasty for primary glenohumeral arthritis

Uribe¹,

Zvijac²,

Porter³

et al. 2021

JSES International

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Background Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid replacement has been introduced in the past; however, clinical evidence remains limited. We hypothesized that patients with advanced glenohumeral arthritis demonstrate significant improvements in pain and function. Methods Prospective patient-reported outcomes (PROs) included the American Shoulder and Elbow Surgeons score, a pain visual analog scale, and satisfaction. Range of motion was compared to the preoperative status. A sensitivity analysis examined responder rates and compared them to literature thresholds using the minimal clinically important difference and substantial clinical benefit. The preoperative glenoid morphology was determined using the Walsh classification. Zone-specific periprosthetic radiolucent lines were quantified at the last follow-up. Results Thirty-nine shoulders in 36 patients (3 bilateral) with a mean age of 65.9 years (26 males, 13 females) and a mean follow-up of 41.0 months were included. Ninety-three percent had grade III osteoarthritis, and 7% grade II. The glenoid Walsh classification included A1 (25%), A2 (25%), B1 (22%), B2 (25%), and C (3%). All PROs improved significantly ( P < .001) with a mean American Shoulder and Elbow Surgeons score from 30.4 to 77.1, a pain visual analog scale from 8.1 to 1.5, and excellent (9.1/10) patient satisfaction. PRO-related responder rates for minimal clinically important difference and substantial clinical benefit were ≥85%. Forward elevation improved from 107° to 155°, and external rotation from 22° to 51°. One intraoperative glenoid rim fracture led to advanced radiolucency; no other clinically relevant lucency was observed. Conclusion Treatment with inlay total shoulder arthroplasty demonstrated significant functional improvement, excellent pain relief, and patient satisfaction in patients with advanced shoulder arthritis and various glenoid morphology types. Our initial results provide further support for this new option in primary shoulder replacement.

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“…Therefore, we started contemplating a definitive treatment by performing a ORIF with bone graft or a shoulder arthroplasty, but at that moment, the patient was lost at follow-up. Given the poor bone quality, after the removal of the EF, we would probably have implanted a hemiarthroplasty or a reverse prosthesis with a press-fit primary humeral stem fixation, considered an optimal choice because of the possible easier revision, decreased operative time, healing time, and resolution of the symptoms [16]. After 7 months, the patient came back to our department, suffering from pain and severe functional limitation, compounded by a preternatural movement of the joint.…”

Section: Discussionmentioning

confidence: 99%

"How COVID-19 Pandemic Indirectly Affected Orthopedic Patients: A Case Report of a Rescue Treatment For a Proximal Humerus Nonunion"

Rm¹,

Reina²,

Nesta

et al. 2021

BJSTR

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The management of proximal humerus fracture is often challenging for orthopedic surgeons. Most of these fractures, in fact, occurs in old women with poor bone quality. Risk of loosening or nonunion and risk of avascular necrosis of humeral head is high, especially in four-parts fractures. We present a case of a 69-year-old woman with proximal humeral nonunion associated with a humeral head osteonecrosis. The peculiarity of this case is that the patient had no follow-up for 7 months because of the Covid-19 pandemic and the restrictions that resulted. We intend to describe how this social situation forced us to change our strategy of treatment and to discuss how to face the possible consequences in orthopedic practice.

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Cemented humeral stemversuspress-fit humeral stem in total shoulder arthroplasty

Cited by 14 publications

References 61 publications

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Inlay total shoulder arthroplasty for primary glenohumeral arthritis

"How COVID-19 Pandemic Indirectly Affected Orthopedic Patients: A Case Report of a Rescue Treatment For a Proximal Humerus Nonunion"

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